The project Overcoming Systems Limitations for Electronic Resources (OSLER) aims to remove barriers to electronic information access for local health care professionals and consumers. The Hospital and doctors' offices lack adequate Internet accessibility, and health care professionals lack knowledge and skills for use of digital information resources. Patients lack Intemet access, and those with access are inundated with large quantities of low-quality health information. OLSER is a joint effort of Noyes Memorial Hospital (NMH) and Tri-County Family Medicine Program (TCFM), which together provide the majority of health care to a rural population in Western New York. OSLER will improve information access and utilization via three main efforts: Placing Internet workstations in clinical care areas within NMH and the seven rural offices of TCFM, and improving informatics skills among health care providers; promoting the acquisition and clinical use of palmtop computers (PDA) for medical database access at points of care; and creating electronic health information kiosks for use by consumers. Internet workstations installed at NMH and TCFM will allow physicians access to resources such as PubMed and Clinicaltrials.gov in the clinical setting. Greater availability of training opportunities, discussions at clinical meetings, recruitment of medical opinion leaders, and utilization of a dedicated Medical Informatician position will promote improved informatics skills. PDA acquisition and use for medical database access at point of care will be promoted by providing training, software, and technical support as well as subsidies for purchase. Databases that are updated via the Internet such as Johns Hopkins Antibiotic Guide and ePocrates will be featured. Electronic health information kiosks will be located for convenient access at Dansville Public Library, NMH lobby, NMH affiliate Livingston Health Services lobby, and Noyes Mental Health Clinic lobby. Configured for ease of use with touch screens, the kiosks will provide links to high quality medical information web sites such as MedlinePlus and CancerNet. Educational sessions on Internet health information retrieval will be held to encourage use and understanding of available resources.